Classification, categorization and essential items for digital ulcer evaluation in systemic sclerosis: A DeSScipher/European Scleroderma Trials and Research group (EUSTAR) survey

EUSTAR co-workers

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: A consensus on digital ulcer (DU) definition in systemic sclerosis (SSc) has been recently reached (Suliman et al., J Scleroderma Relat Disord 2:115-20, 2017), while for their evaluation, classification and categorisation, it is still missing. The aims of this study were to identify a set of essential items for digital ulcer (DU) evaluation, to assess if the existing DU classification was useful and feasible in clinical practice and to investigate if the new categorisation was preferred to the simple distinction of DU in recurrent and not recurrent, in patients with systemic sclerosis (SSc). Methods: DeSScipher is the largest European multicentre study on SSc. It consists of five observational trials (OTs), and one of them, OT1, is focused on DU management. The DeSScipher OT1 items on DU that reached ≥ 60% of completion rate were administered to EUSTAR (European Scleroderma Trials and Research group) centres via online survey. Questions about feasibility and usefulness of the existing DU classification (DU due to digital pitting scars, to loss of tissue, derived from calcinosis and gangrene) and newly proposed categorisation (episodic, recurrent and chronic) were also asked. Results: A total of 84/148 (56.8%) EUSTAR centres completed the questionnaire. DeSScipher items scored by ≥ 70% of the participants as essential and feasible for DU evaluation were the number of DU defined as a loss of tissue (level of agreement 92%), recurrent DU (84%) and number of new DU (74%). For 65% of the centres, the proposed classification of DU was considered useful and feasible in clinical practice. Moreover, 80% of the centres preferred the categorisation of DU in episodic, recurrent and chronic to simple distinction in recurrent/not recurrent DU. Conclusions: For clinical practice, EUSTAR centres identified only three essential items for DU evaluation and considered the proposed classification and categorisation as useful and feasible. The set of items needs to be validated while further implementation of DU classification and categorisation is warranted. Trial registration: Observational trial on DU (OT1) is one of the five trials of the DeSScipher project (ClinicalTrials.gov; OT1 Identifier: NCT01836263, posted on April 19, 2013).

Original languageEnglish
Article number1822
JournalArthritis Research and Therapy
Volume21
Issue number1
DOIs
Publication statusPublished - Jan 24 2019

Fingerprint

Systemic Scleroderma
Ulcer
Research
Surveys and Questionnaires
Calcinosis
Gangrene

Keywords

  • Categorisation
  • Classification
  • Digital ulcers
  • Essential items
  • Systemic sclerosis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

@article{5ff6890e80e743b68ccbace02c9f3ea7,
title = "Classification, categorization and essential items for digital ulcer evaluation in systemic sclerosis: A DeSScipher/European Scleroderma Trials and Research group (EUSTAR) survey",
abstract = "Background: A consensus on digital ulcer (DU) definition in systemic sclerosis (SSc) has been recently reached (Suliman et al., J Scleroderma Relat Disord 2:115-20, 2017), while for their evaluation, classification and categorisation, it is still missing. The aims of this study were to identify a set of essential items for digital ulcer (DU) evaluation, to assess if the existing DU classification was useful and feasible in clinical practice and to investigate if the new categorisation was preferred to the simple distinction of DU in recurrent and not recurrent, in patients with systemic sclerosis (SSc). Methods: DeSScipher is the largest European multicentre study on SSc. It consists of five observational trials (OTs), and one of them, OT1, is focused on DU management. The DeSScipher OT1 items on DU that reached ≥ 60{\%} of completion rate were administered to EUSTAR (European Scleroderma Trials and Research group) centres via online survey. Questions about feasibility and usefulness of the existing DU classification (DU due to digital pitting scars, to loss of tissue, derived from calcinosis and gangrene) and newly proposed categorisation (episodic, recurrent and chronic) were also asked. Results: A total of 84/148 (56.8{\%}) EUSTAR centres completed the questionnaire. DeSScipher items scored by ≥ 70{\%} of the participants as essential and feasible for DU evaluation were the number of DU defined as a loss of tissue (level of agreement 92{\%}), recurrent DU (84{\%}) and number of new DU (74{\%}). For 65{\%} of the centres, the proposed classification of DU was considered useful and feasible in clinical practice. Moreover, 80{\%} of the centres preferred the categorisation of DU in episodic, recurrent and chronic to simple distinction in recurrent/not recurrent DU. Conclusions: For clinical practice, EUSTAR centres identified only three essential items for DU evaluation and considered the proposed classification and categorisation as useful and feasible. The set of items needs to be validated while further implementation of DU classification and categorisation is warranted. Trial registration: Observational trial on DU (OT1) is one of the five trials of the DeSScipher project (ClinicalTrials.gov; OT1 Identifier: NCT01836263, posted on April 19, 2013).",
keywords = "Categorisation, Classification, Digital ulcers, Essential items, Systemic sclerosis",
author = "{EUSTAR co-workers} and J. Blagojevic and S. Bellando-Randone and G. Abignano and J. Avouac and L. Cometi and L. Czirj{\'a}k and Denton, {C. P.} and O. Distler and M. Frerix and S. Guiducci and D. Huscher and Jaeger, {V. K.} and V. L{\'o}r{\'a}nd and B. Maurer and S. Nihtyanova and G. Riemekasten and E. Siegert and Tarner, {I. H.} and S. Vettori and Walker, {U. A.} and Y. Allanore and U. M{\"u}ller-Ladner and {Del Galdo}, F. and M. Matucci-Cerinic",
year = "2019",
month = "1",
day = "24",
doi = "10.1186/s13075-019-1822-1",
language = "English",
volume = "21",
journal = "Arthritis Research and Therapy",
issn = "1478-6354",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Classification, categorization and essential items for digital ulcer evaluation in systemic sclerosis

T2 - A DeSScipher/European Scleroderma Trials and Research group (EUSTAR) survey

AU - EUSTAR co-workers

AU - Blagojevic, J.

AU - Bellando-Randone, S.

AU - Abignano, G.

AU - Avouac, J.

AU - Cometi, L.

AU - Czirják, L.

AU - Denton, C. P.

AU - Distler, O.

AU - Frerix, M.

AU - Guiducci, S.

AU - Huscher, D.

AU - Jaeger, V. K.

AU - Lóránd, V.

AU - Maurer, B.

AU - Nihtyanova, S.

AU - Riemekasten, G.

AU - Siegert, E.

AU - Tarner, I. H.

AU - Vettori, S.

AU - Walker, U. A.

AU - Allanore, Y.

AU - Müller-Ladner, U.

AU - Del Galdo, F.

AU - Matucci-Cerinic, M.

PY - 2019/1/24

Y1 - 2019/1/24

N2 - Background: A consensus on digital ulcer (DU) definition in systemic sclerosis (SSc) has been recently reached (Suliman et al., J Scleroderma Relat Disord 2:115-20, 2017), while for their evaluation, classification and categorisation, it is still missing. The aims of this study were to identify a set of essential items for digital ulcer (DU) evaluation, to assess if the existing DU classification was useful and feasible in clinical practice and to investigate if the new categorisation was preferred to the simple distinction of DU in recurrent and not recurrent, in patients with systemic sclerosis (SSc). Methods: DeSScipher is the largest European multicentre study on SSc. It consists of five observational trials (OTs), and one of them, OT1, is focused on DU management. The DeSScipher OT1 items on DU that reached ≥ 60% of completion rate were administered to EUSTAR (European Scleroderma Trials and Research group) centres via online survey. Questions about feasibility and usefulness of the existing DU classification (DU due to digital pitting scars, to loss of tissue, derived from calcinosis and gangrene) and newly proposed categorisation (episodic, recurrent and chronic) were also asked. Results: A total of 84/148 (56.8%) EUSTAR centres completed the questionnaire. DeSScipher items scored by ≥ 70% of the participants as essential and feasible for DU evaluation were the number of DU defined as a loss of tissue (level of agreement 92%), recurrent DU (84%) and number of new DU (74%). For 65% of the centres, the proposed classification of DU was considered useful and feasible in clinical practice. Moreover, 80% of the centres preferred the categorisation of DU in episodic, recurrent and chronic to simple distinction in recurrent/not recurrent DU. Conclusions: For clinical practice, EUSTAR centres identified only three essential items for DU evaluation and considered the proposed classification and categorisation as useful and feasible. The set of items needs to be validated while further implementation of DU classification and categorisation is warranted. Trial registration: Observational trial on DU (OT1) is one of the five trials of the DeSScipher project (ClinicalTrials.gov; OT1 Identifier: NCT01836263, posted on April 19, 2013).

AB - Background: A consensus on digital ulcer (DU) definition in systemic sclerosis (SSc) has been recently reached (Suliman et al., J Scleroderma Relat Disord 2:115-20, 2017), while for their evaluation, classification and categorisation, it is still missing. The aims of this study were to identify a set of essential items for digital ulcer (DU) evaluation, to assess if the existing DU classification was useful and feasible in clinical practice and to investigate if the new categorisation was preferred to the simple distinction of DU in recurrent and not recurrent, in patients with systemic sclerosis (SSc). Methods: DeSScipher is the largest European multicentre study on SSc. It consists of five observational trials (OTs), and one of them, OT1, is focused on DU management. The DeSScipher OT1 items on DU that reached ≥ 60% of completion rate were administered to EUSTAR (European Scleroderma Trials and Research group) centres via online survey. Questions about feasibility and usefulness of the existing DU classification (DU due to digital pitting scars, to loss of tissue, derived from calcinosis and gangrene) and newly proposed categorisation (episodic, recurrent and chronic) were also asked. Results: A total of 84/148 (56.8%) EUSTAR centres completed the questionnaire. DeSScipher items scored by ≥ 70% of the participants as essential and feasible for DU evaluation were the number of DU defined as a loss of tissue (level of agreement 92%), recurrent DU (84%) and number of new DU (74%). For 65% of the centres, the proposed classification of DU was considered useful and feasible in clinical practice. Moreover, 80% of the centres preferred the categorisation of DU in episodic, recurrent and chronic to simple distinction in recurrent/not recurrent DU. Conclusions: For clinical practice, EUSTAR centres identified only three essential items for DU evaluation and considered the proposed classification and categorisation as useful and feasible. The set of items needs to be validated while further implementation of DU classification and categorisation is warranted. Trial registration: Observational trial on DU (OT1) is one of the five trials of the DeSScipher project (ClinicalTrials.gov; OT1 Identifier: NCT01836263, posted on April 19, 2013).

KW - Categorisation

KW - Classification

KW - Digital ulcers

KW - Essential items

KW - Systemic sclerosis

UR - http://www.scopus.com/inward/record.url?scp=85060511429&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060511429&partnerID=8YFLogxK

U2 - 10.1186/s13075-019-1822-1

DO - 10.1186/s13075-019-1822-1

M3 - Article

C2 - 30678703

AN - SCOPUS:85060511429

VL - 21

JO - Arthritis Research and Therapy

JF - Arthritis Research and Therapy

SN - 1478-6354

IS - 1

M1 - 1822

ER -